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Abstract

Objective Depression is associated with IBD, but the effect of antidepressants on IBD has been sparsely studied. We assessed the impact of depression and antidepressant therapies on the development of IBD.

Design The Health Improvement Network (THIN) was used to identify a cohort of patients with new-onset depression from 1986 to 2012. THIN patients who did not meet the defining criteria for depression were part of the referent group. The outcome was incident Crohn’s disease (CD) or ulcerative colitis (UC). Cox proportional hazards modelling was performed to evaluate the rate of Crohn’s disease or UC development among patients with an exposure of depression after controlling for age, sex, socioeconomic status, comorbid conditions, smoking, anxiety and antidepressant use including atypical antidepressants, mirtazapine, monoamine oxidase inhibitors (MAOI), serotonin norepinephrine reuptake inhibitors (SNRI), selective serotonin reuptake inhibitors (SSRI), serotonin modulators; and tricyclic antidepressants (TCA).

Conclusion Patients with a history of depression were more likely to be diagnosed with IBD. In contrast, antidepressant treatments were selectively protective for Crohn’s disease and UC. These results may impact counselling and management of depression and IBD.

Funding This work was funded through a Canadian Institutes of Health Research Team Grant in Inflammation in Chronic Disease. Grant ID: THC –135231.

Competing interests MGS, AAS and GGK share a patent: TREATMENT OF INFLAMMATORY DISORDERS, AUTOIMMUNE DISEASE, AND PBC. UTI Limited Partnership, assignee. Patent 62/555,397. 7 September 2017. GGK has served as a speaker for Janssen, AbbVie and Pfizer, and has received research support from Janssen, AbbVie, GlaxoSmithKline and Shire.

Ethics approval The Conjoint Health Research Ethics Board at the University of Calgary (ID: 24423) and the UK’s IMS Health Scientific Review Committee approved the study protocol (ID: 16THIN052).

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